Orient (e. g. during the Crusades) the usage seems to liave been tacitly allowed to continue.
First Univeusitif.s in the West. — Having volun- tarily undertaken the education of the young in all liranches of learning, the monasteries were aided in their enilcavours by both Church and State. The foundation of state schools is the work of Charlemagne (7(58-814), whose activhy, especially in the Germanic countries, was stimulated by the decree of the Synod of .\aehen (7s!i), that each monastery and each cathe- dral cliapter should institute a school. According to the Capitulary of Charlemagne at Diedenhofen (Thion- ville) in SOti, medicine was commonly taught in these schools. At the diocesan school in Reims, we find Gerbert d'Aurillae, later Pope Sylvester II (999- 1003), long active as a teacher of medicine. Simul- taneously with the rise of the cities there .sprang up higher municipal schools, as for instance the Burger- srhule at St. Stephan's in Vienna (about 1237). Out of the secular and religious schools, the curriculum of which institutions comprised the entire learning of the times, the first universities developed themselves, partly imder imperial and partly under papal protec- tion, according as they sprang from the lay and the cathedral or monastic schools.
School of S.\lerno. — This is regarded as the oldest medical school of the West. Salerno on the Tyrrhe- nian Sea, originally probably a Doric colony, was from the sixth to t^ie eleventh century under the rule of the Lombards, and from 1075 to 1130 under that of the Normans. In 1130 it became a part of the Kingdom of Naples and Sicily. The origin of the school is ob- scure, but, contrary to former belief, it was not a re- ligious foundation, though very many priests were en- gaged there as teachers of medicine. Women and even Jews were admitted to these studies. Salerno was destined to cultivate for a long time Greek medi- cal science in undimmed purity, until the twelfth cen- tury saw the school fall a victim to the all-powerful Arab influence. One of its oldest physicians was Alpuhans, later (10.58-85) ArchbLshop of Salerno. With him worked the Lombard Gariopontus (d. 1050), whose " Passionarius " is based upon Hippocrates, Galen, and Cselius Aurelianus. Contemporary with him was the female physician Trotula, who worked also in the literary field, and who Ls said to have been the wife of the physician Joannes Platearius. Per- haps the best known literary work of this school is the anonjTnous "Regimen sanitatis Salemitanum", a diilactic poem consisting of 364 stanzas, which has been translated into all modem languages. It is said to have been dedicated to Prince Robert., son of William the Conqueror, upon his departure from Salerno in 1101. An important change in the intellectual ten- dency of the "Civitas Hippocratica", as this school called itself, was brought about by the physician Con- stantine of Carthage (Constantinus Africanus), a man learned in the Oriental languages and a teacher of medicine at Salerno, who died in 1087 a monk of Monte Cassino. While hitherto the best works of Greek antiquity had been known only in mediocre Latin translations, Constantine in the solitude of Monte Cassino began to translate from the Arabic Greek authors (e. g. the "Aphorisms" of Hippocrates and the " Ars parva " of Galen), as well as such Arabic writers as were accessible to him (Isaak, Ali Abbas). A.S he brought to the knowledge of his contemporaries first class Greek authors, but only secondary Arab writers, the study of the former became more pro- found, while on the other hand an interest was awak- ened in the hitherto unknown Arabic literature. His pupils were Bartholomceus, whose "Practica" was translated into German as early as the thirteenth cen- tury, and Johannes Afflacius (De febribus et urinis). To the twelfth century, when Arabian polypharmacy was introduced, belong Nicolaus Propositus (about 1140), whose " Antidotarium", a collection of com-
pounded pharmaceutical formuhe, became a model for later works of this kind, and Wattha'us Platearius, who, towards the end of the century, wrote a commen- tary on the al)Ove-named " Antidotarium " (Glossa") andaworkaboutsimpledrugs (Circa instans). Similar productions appeared from the hand of an otherwi.sc unknown M agister Salcrnitanus. Maurus, following Arabian sources, wrote on uroscopy. Here must be also mentioned Petrus Musandinus (De cibis et potibus febricitantium), the teacher of Pierre Giles of Corbeil (yEgidius Corboliensis), who later became a canon and the physician-in-ordinary to Philip Augus- tus of I'>ance (1180-1223), and who even at this day began to complain about the decay of the school.
Its first misfortune dates from the death of King Roger in (1193), when the army of King Henry VI captured the city. The establishment of the I'niver- sity of Naples by Frederick II in 1224, the preponder- ance of Arabian influence, and the rise of the Mont- pellier school, all exerted so unfavourable an influence that by the fourteenth century Salerno was well-nigh forgotten. Salerno is the oldest school having a curriculum prescribed by the state. In 1140 King Roger II ordered a state examination to test the pro- ficiency of prospective physicians, and Frederick II in 1240 prescribed five years of study besides a year of practical experience. When we consider the prox- imity of Northern Africa, that the neighbouring Sicily had been under Saracenic rule from the ninth to the eleventh century, and that the Norman kings, and to a far greater degree Frederick II, gave powerful protec- tion to Arabian art and science, it seems wonderful that this oasis of Gra>co-Roman culture endured so long. Down to the twelfth century this school was ruled by a purely Hippocratic spirit, especially in practical medicine, by its diagnosis and by the treat- ment of acute diseases dietetically. Arabian influence makes itself felt first of all in therapeutics, a fact which Is easily explained by the proximity of Amalfi, where the Arabian drug-dealers used to land. Local condi- tions (resulting from the Crusades) explain how sur- gery, especially the treatment of wounds received in war, was diligently cultivated. In Rogerius we find a Salemitan surgeon armed with independent experi- ence, but showing, nevertheless, reminiscences of Abulhasem. His "Practica Chirurgiaj" dates from the year 1180. Although Salerno finally succumbed to Arabian influences, this school did not hand down to us a knowledge of the best Arabian authors.
Spain as the Tr,\nsmitter of Arabian Medicine. — Its focus was the city of Toledo, which was taken from the Moors in 1085 by Alfonso VI of Castile and Leon. Here Archbishop Ralmund (1130-50) founded an Institution for translations. In which Jewish schol- ars were the chief workers. Here lived Gerard of Cremona (1114-87, properly Carmona, near Seville), the translator of Rhazes and Avicenna. A later trans- lator of Rhases (about 1279) was the Jew Faradsch ben Salem (Faragius), who was educated at Salerno.
The Scholastic Period. — When In the twelfth century all the Arlstotelean works gradually became known, one of the results was the development of scholasticism, that logically arranged systematic treatment and explanation of rational truths based upon the Arlstotelean speculative method. Even though this tendency led to the growth of many ex- crescences in medicine and confirmed the predomi- nance of Galen's system, also largely based on specula- tion, it is wrong to hold Scholasticism responsible for the mistakes which its disciples made in consequence of their faulty apprehension of the system, becau.se scholasticism, far from excluding the observation of nature, directly promotes it. The best proof of this is the fact that the most important scholastic of the thirteenth century, Albertus Magnus, was likewise the most important physicist of his time. He thus imi- tated his model, Aristotle, in both directions. The